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Presbyopia is an age-related vision condition, typically occurring after45, affecting near vision. It stems from the lens losing flexibility, hindering focus on close objects. Common symptoms include eye strain, difficulty reading, or needing more light. Treatment options involve corrective surgery such as refractive lens exchange (RLE) or laser vision correction to achieve blended vision.
Blended vision is where one eye is corrected for distance vision while the other eye is adjusted for near vision. By deliberately creating this difference in focus between the eyes, the brain adapts to seamlessly integrate both views, allowing for clearer vision at various distances.
Blended vision correction aims to provide a more natural and comprehensive range of sight, reducing dependence on glasses or contact lenses for various activities. While adjustments might be necessary initially as the brain adapts to this new way of seeing, many individuals find this approach highly effective in managing presbyopia and achieving clearer vision across different distances.
Other ways include the use of enhanced depth of focal lenses (EDOf) or multifocal lenses, each addressing different visual needs.
Multifocal lenses are intraocular lenses (IOLs) used in cataract surgery or as standalone procedures for individuals with presbyopia. These lenses have distinct zones with varying focal lengths, enabling clear vision at different distances simultaneously—near, intermediate, and distance. By distributing light across multiple focal points, they provide a broader range of vision, reducing the reliance on glasses or contacts for various tasks.
On the other hand, Extended Depth of Focus (EDOF) lenses function by extending the range of clear vision without creating distinct focal points. These lenses utilise advanced optical designs to elongate the depth of focus, allowing for enhanced vision across a continuum of distances—enabling better clarity for both near and intermediate vision while maintaining satisfactory distance vision.
The choice between multifocal and EDOF lenses depends on individual preferences, lifestyle, and visual needs. Consulting with an eye care professional is crucial to determine the most suitable option for correcting presbyopia. They can assess factors like eye health, existing conditions, and personal preferences to recommend the most appropriate lens type for achieving optimal visual outcomes and improving near vision in individuals with presbyopia.
What is Glaucoma?
Glaucoma is a disease that damages the nerve at the back of your eye, called the optic nerve. The optic nerve sends the signals to the brain that enables you to see. Glaucoma is associated with increased sensitivity to pressure within the eye. The eye’s aqueous fluid is constantly produced and drained at a balanced rate and forms the intraocular pressure within the eye (IOP). When this drainage is reduced, or if there is too much fluid production, IOP increases and leads to damage of the optic nerve.
Image of the optic nerve showing loss of nerve cells in patients with glaucoma.
Glaucoma typically has no symptoms. Most patients do not experience any issues until they visit their eyecare provider. Untreated glaucoma can cause a gradual loss of vision, usually starting in the periphery which may go unnoticed for long periods of time.
Image showing the effect of loss of sight in patients with glaucoma.
Our Process :
Assessment
Detailed measurements of the eyes are taken for safety and accuracy, and the team will discuss your options. It's essential to have a detailed assessment & conversation with our team at Re:Vision, to see what procedure you are most suitable for.
Meet your surgeon
Usually, at the same visit, you will meet your surgeon who will thoroughly examine your eye and discuss your eyesight problems and treatment options. You will have an opportunity to discuss various procedures such as laser vision correction, lens replacement with a variety of premium lenses as well as blended vision.
On the day
The entire procedure is usually done in less than 30 minutes for both eyes, and you'll be amazed at how quick and straightforward it is! The best part is that you'll notice the results almost immediately. You will be able to see immediately after laser or lens replacement and over the next few days, your eyes will continue to heal and improve. Your eyes are not patched, you go home wearing clear plastic protective shields to protect your eyes as they heal overnight.
Recovery
After the procedure, you will be given some simple care instructions to follow, like using eye drops and avoiding rubbing your eyes. You might need a little rest and take it easy for a day or two, but most people can get back to their regular activities pretty quickly.
Check
A follow-up appointment the next day will check how you are feeling and measure how much better your eyesight is. The vision recovers quickly, with the vast majoirty of patients regaining driving standard vision without glasses the next day but most people have 1 or 2 quiet days afterwards.
5 most common reasons patients have LASIK eye surgery :
Improved Vision :
LASIK can significantly improve high definition vision, allowing people to see clearly without relying on glasses or contact lenses. This is a huge benefit for people who’ve been struggling with poor vision for years.
Convenience :
For those always on the go or have an active outdoor lifestyle, a life not limited by glasses or contacts is a huge lift.
Cost Savings :
Over time, the cost of glasses and/or contact lenses, all add up. LASIK is a very cost-effective solution to reduce long-term expenses related to vision correction.
Safety :
With advances in laser technology, the small risks associated with LASIK have become increasingly minimal. Risks are minimised by choosing an experienced specialist laser surgeon who uses the latest laser technology.
Improved Self-Confidence :
For many, wearing glasses or contact lenses can be a source of self-consciousness. LASIK helps to improve self-confidence and allow people to feel more comfortable in their own skin.
Saving money
The hidden costs: what could you save?
What could that money have done?
The $40,000 you'd potentially spend on glasses and contact lenses over the next 30 years could have given you 15 luxurious holidays.
Est - 15 Holidays
Average holiday cost: $2600
Calculation: 40,000 / $2600 = 15
Saving time
The hidden cost of wearing glasses or contact lenses.
Did you know?
The time you'd spend handling glasses and contact lenses over the next 30 years is enough to have could have taken you around our planet over 30 times!
Est- 526 hours
Cleaning: 3 minutes/day
Finding misplaced glasses: 2 minutes/day
Repair, shopping: 2 hours/year
Total: 526 hours (over 30 years)
Est- 526 hours
Inserting and Removing: 3 minutes/day
Cleaning: 2 minutes/day
Renewing & Check-ups: 2 hours/year
Total: 1,012 hours (over 30 years)
Saving planet
Reducing our carbon footprint
The environmental perspective
Over 30 years, using glasses and contact lenses contributes to 876lb of CO2 emissions. Opt for vision correction and take a stand for our planet!
Est- 876.6 CO2 emissions
Combined plastic waste:
0.525 kg (glasses)+65.7 kg (contact lenses)=66.225 kilograms over three decades.
Total: 66.225 kilograms of plastic×6=397.35 kilograms = 876Lb of CO2 emissions(over 30 years)
Safe
We use the newest laser & lens technology available in New Zealand to provide unequaled safety, care, and quality of vision. Our surgeons have also published widely on the safety of laser & lens-based vision correction procedures.
Proven
Many millions of individuals have had presbyopia correction using laser & lens-based technologies.
Short Surgery Time
It typically takes 10-15 minutes to perform the surgery per eye .
Personalised Surgical Care
Some patients are not suitable for drops or laser therapy and require either cataract surgery, minimally invasive glaucoma surgery or complex glaucoma surgery.
Minimally invasive Glaucoma surgery (MIGS) marks a milestone in the advancement of glaucoma patient care. MIGS are a form of glaucoma surgery which is associated with minimal incisions, and are generally associated with lower risks in restoring normal eye pressure.
Prior to MIGS, treatment options were limited to medications, laser and major glaucoma tube and filtration surgery. Now, with MIGS, our team at Re:Vision have more treatment options which benefits a patient with faster recovery , less surgical risks and less dependence on medications following surgery.
Our surgeon is a leader in MIGS surgery in NZ, with a wealth of experience with iStent -W, Kahook Dual Blade, Hydrus, XEN, Preserflo, micropulse and cyclodiode laser.
MIGS management include:
1) Various treatment options and benefits which are patient centric and individualised
2) Evidence based therapy and
3) Promising outcomes for glaucoma patients.
MIGS can be performed as a standalone procedure or in conjunction with cataract surgery. There are different surgical approaches under the MIGS umbrella, but they generally are designed to allow more fluid to drain out of the eye and hence, reduce intraocular pressure.
a) iStent
The iStent is the smallest medical device ever implanted into humans. The iStent decreases eye pressure by creating a pathway into the eye’s drainage system. The iStent was the first trabecular micro-bypass device approved by the FDA and is the most thoroughly-studied glaucoma device on the market.
Click here to watch video on iStent
b) Kahook Dual Blade
The Kahook Dual Blade goniotomy procedure involves removing a section of the trabecular meshwork (the part which is associated with the greatest resistance in fluid outlflow) and hence increasing drainage out of the eye.
Click here for information on KDB
c) Micropulse Laser Treatment
This procedure decreases the amount of fluid produced by the eye and increases fluid outflow. A probe is placed on the surface of the eye and the surgeon applies laser energy to part of the eye which controls the production of fluid in the eye.
d) Preserflo Stent
The Preserflo drainage shunt is type of microshunt implant used to reduced intraocular pressure by creating a controlled pathway for the drainage of fluid out of the eye. It is made from a specialised biocompatible material called SIBS, which is known for its stability, flexibility and compatibility with the human body, hence minimising tissue inflammation.
Click here for information on Preserflo
Trabeculectomy surgery has been done for more than 50 years, and involves making a separate channel for fluid to filter out of the eye.
A drainage tube is a device inserted into the eye, which acts as straw where fluid can access to drain out of the eye onto the outer coat of the eye. There are several drainage tubes available in NZ which include Molteno drainage tube, Paul drainage tube and Baerveldt drainage tube.
Generally, these surgeries are done once all others have been exhausted and have failed to stop the progression of glaucoma.
Glaucoma is optic nerve damage due to increased pressure sensitivity within the eye while a cataract is a clouding of your natural lens within your eye.
In some patients, the hardening and change in the shape of the lens with the development of cataract, can potentiate the effects of glaucoma, such as angle closure glaucoma. In this situation, we may suggest having cataract surgery as a way to treat your glaucoma.
Some patients can combine glaucoma and cataract surgery (includes patients with open angle glaucoma). MIGS procedures in particular can be performed through the same incision as cataract surgery, providing an efficient way to address two problems at once.
Our Technology:
Peramis Wavefront Aberrometer
There are 25 measurable causes of defocus in our eyes. These defocus errors are called aberrations and are precisely measured by an aberrometer. With accurate measuring and laser treatment of these aberrations, we can achieve high-definition vision even clearer than glasses can provide. Older laser technologies, and SMILE, only measure and treat 2 defocus errors, compared to 25. Wavefront aberrometers allow laser surgeons to precisely analyse the optics of the eye. The Peramis aberrometer has six times higher resolution than other systems. This exceptional performance is based on a high-resolution pyramidal wavefront sensor that measures ocular wavefront aberrations with an unequaled 45,000 measuring points. Together with the integrated high-resolution topography with Placido technology, this allows for an extremely accurate assessment of corneal and ocular aberrations. This data allows your surgeon to individually customise the wavefront-based correction of your vision.
Sirius Tomographer
Combines Placido disk topography with Scheimpflug tomography of the front of the eye to allow the surgeon to perform the safest version of laser vision correction customised to your eyes. The device provides highly accurate measurements of corneal thickness, curvature, power as well as pupil size measurements and is commonly used for refractive surgery planning and follow-up.
Custom Built Surgical Facility
Re:Vision Laser & Cataract was specifically designed and created by our surgeons to provide maximum safety for patients in need of eye surgery. We are fully accredited by the Designated Auditing Agency (DAA) with an excellent scoring.
Schwind Amaris 1050RS excimer laser
Considered the world’s most precise excimer laser for vision correction used in LASIK and PRK. The more precise the laser, the more precise the vision correction. The Schwind Amaris 1050 laser is equipped with 7-dimensional eye tracking for accurate delivery of laser pulses with compensation for the slightest eye movement during surgery.
Smart-pulse technology leaves the smoothest possible corneal surface leading to exceptional visual quality and high-definition vision.
IOL master 700
The IOLMaster 700 provides highly repeatable and accurate measurements of the eye to allow the surgeon to customise the lens implant in your eye following cataract or RLE surgery. The device provides highly accurate lens thickness, anterior chamber depth, and corneal thickness measurements of the eye. The entire process is completed in about 50 seconds, with a total of 2,000 scans taken per second. During the process, the IOLMaster 700 also performs a 1-mm central retinal scan.
Ziemer Z6 Femtosecond Laser
The Ziemer Z6 solid-state femtosecond laser provides unmatched safety and predictability for corneal flap creation – the first stage in the LASIK procedure. It provides faster overnight vision recovery and higher-definition vision. The Ziemer Z6 laser has the highest repetition rate of any femtosecond laser with overlapping, precise spots with the lowest most gentle energy delivery of all laser systems. This avoids the formation of opaque bubbles during LASIK flap creation which aids accurate eye tracking and results in rapid visual recovery.
Zeiss Lumera operating microscope with Callisto virtual guidance system
The integral Callisto system in this microscope provides intelligent real time image guidance for incision and toric lens alignment for better management of astigmatism during surgery.
Centurion phacoemulsification machine
This is a highly advanced device utilises cutting edge technology to reduce ultrasound energy output, fluid volume used as well as surgical time to improve safety, consistency and control during cataract surgery.
Glaucoma Research at Re:Vision
Dr Perumal values the importance of research initiatives and technology in glaucoma. We may invite you to participate in the Save Sight Registry run by the Save Sight Institute, in collaboration with the University of Sydney and Sydney Eye Hospital to fight glaucoma blindness.
The Save Sight Registries is one of the most advanced ophthalmic registries in the world, and is a unique platform for tracking eye disease, interventions and patient outcomes. Its sophisticated design delivers real-world evidence on the risks and benefits of current and new treatments for ocular conditions. This information helps clinicians provide safe, cost-effective and evidence-based solutions for vision impairment and avoidable blindness.
The Save Sight Registries also promotes international scientific research aimed at developing strategies for reducing the incidence of blindness throughout the world.
How much does presbyopia correction cost?
Presbyopia correction costs depends on whether the most suitable treatment for you is with laser or lens exchange surgery. Whilst our laser costs are standard, RLE surgery costs depend on the type of lens best suited to your eyes.
By the time I turn 45, I will have spent on contact lenses/glasses :
At Re:Vision, all types of laser vision correction
(LASIK or PRK) cost : $3,599/eye
Get Started
References :
- Tavassoli S, Ziaei H, Yadegarfar ME, Evans J, Ziaei M. Trifocal versus extended depth of focus (EDOF) intraocular lenses for cataract extraction, Cochrane Database of Systematic Reviews, 2021
- Evans JR, de Silva SR, Ziaei M, Kirthi V, Leyland MD. Outcomes in randomised controlled trials of multifocal lenses in cataract surgery: the case for development of a core outcome set. Br J Ophthalmol. 2020.
- De Silva SR, Evans JR, Kirthi V, Ziaei M, Leyland M. Multifocal versus monofocal intraocular lenses after cataract extraction. Cochrane Database Syst Rev. 2016 Dec.
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